New cast/setting ankle @ 90 degrees

New cast/setting ankle @ 90 degrees

February 21, 2013

Today was New Cast Day. I picked hot pink for this one. The plan was to set the ankle @ 90 degrees. The cast came off without issue (read: I did not pass out or puke–which are my norm). I was pleasantly surprised at the leg’s appearance. Yes, still Zombie Leg, but less atrophy than I expected and the skin looked dry but healthy. The doc had me lie on my stomach for him to flex the ankle. THAT was an “attention getter”! Dang, he was rough.

Interesting that the pain was on the outside of the bottom of the foot and the tendons up the side of the leg–not the Achilles or the back of the leg. My heel is completely numb-zero sensation.

This cast is lower than the previous one and the “sole” hits right behind the ball of my foot. The latter is not terribly comfortable.

Image Outside vew closer resized Inside view resized Outside view resized Pink cast resized

3 Responses to “New cast/setting ankle @ 90 degrees”

  1. I’m not sure how I missed your late-Feb blog posts, Jenny, but I think I’ve caught up now. I’ve had 2 ATRs, both sides now, 8 yrs apart. Both were totally pain-free apart from the first moments, the discomfort from swelling, and the week of post-op moaning and groaning after the surgery for ATR #1. I skipped the surgery for ATR#2, so it stayed pain-free. (And let’s just say that if Christ arranged my lack of pain, it would be Very Ironic!)

    BTW, I’m not sure you’ve noticed this irony, but: virtually 100% of us here who tore our ATs by over-stressing them, were ABSOLUTELY SURE that somebody had stepped on or kicked the back of our leg, but nobody had — and that apparently really happened to you!! First time I’ve heard THAT story, and it’s a real switcheroo!

    Your Surgeon reminds me of mine back in 2001-02, ATR #1 — conservative, old-school, set in his ways. He did mostly hip and knee replacements, thought he could treat an ATR in his sleep, and treated me like a geezer (at ~57), rather than a competitive volleyball player who wanted to get back on the court — and the small sailboat, and the bicycle, etc. He was a fine fellow and a very good surgeon, but our short meetings were tense. He was used to being treated like God, and I’d read much more of the literature on ATRs than he had. He had all the old time-worn excuses for going slowly well rehearsed — “Better safe than sorry,” “You don’t want to have to go through this TWICE,” etc. etc. — but I’d read the studies showing that long slow immobilization did NOT reduce rerupture rates or produce superior results, and might even do the opposite.

    I basically proceeded as if he owned my leg, and not me, trying to persuade him (in rare 5-minute bursts!) rather than defying him. THREE casts and way too many weeks later, I became his first patient EVER to be put in an orthotic boot.

    The good news is that my return to competitive volleyball was fine and not especially late, at 10-11 months post-op. The evidence on post-op early WB (as I read it) shows pretty little impact on eventual clinical outcomes — no benefit to justify the nuisance and lack of productivity from long slow immobilization, but little or no clinical penalty, either. (For non-op patients, there IS a clear clinical penalty from long immobilization.)

    So if you want to be a nice docile patient, you will probably end up recovering about as well as if you’d gone with a modern fast state-of-the-art rehab, though you’ll be relatively helpless and unproductive for much longer.

  2. Hey Normof thenorth,

    You did not miss any posts–I just uploaded the blog to this site yesterday.
    I don’t know for certain, but is suspect one reason the Dr. has kept me in a cast is where/how I live. I am on a farm with VERY steep hills and soil that grows great rocks. LOL! There is no level ground here and no pavement. So there may be a greater likelihood of my taking a tumble and being injured in doing so.
    Yes, I am in week 10 of “helpless” and minimally productive–though I have done a good bit of long overdue computer work..
    The cast comes off on Monday, March 25th! I can’t wait!!

  3. Good luck, Jenny. I think most boots are as protective agains rocks and such as most FG casts. But both are WAY more protective than a shoe. Soon after I got into 2 shoes this 2d time around, I walked around my sailig club, which was covered in big hard pine cones — not the square ones we’ve been discussing in a (very) different context, but still SCARY. No reinjury, but I was very nervous — fearful of “ordinary” twisted ankles more than AT injury. (All the muscles etc. that stabilize the ankle in all directions are weak and “rusty” after immobilization, even with a quick protocol like UWO. We all assume it’s even worse with slower rehab.

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